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    18 August 2017, Volume 21 Issue 23 Previous Issue    Next Issue
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    Safety and efficacy of a novel knee prosthesis for knee arthroplasty: study protocol for a prospective, randomized, positive parallel controlled, non-inferiority, clinical trial
    Li Zhi-feng, Sun Jing-dong, Zhang Jiang, Gong Tai-fang
    2017, 21 (23):  3609-3615.  doi: 10.3969/j.issn.2095-4344.2017.23.001
    Abstract ( 470 )   PDF (1289KB) ( 281 )   Save

    BACKGROUND: Total knee arthroplasty is the main treatment for end-stage knee disease. However, knee prostheses are mostly imported from overseas, making the price expensive. Furthermore, ethnic differences mean that these prostheses designed for westerners are not designed to meet the needs of Orientals.

    OBJECTIVE: To verify the efficacy and safety of this novel knee prosthesis in total knee arthroplasty.
    METHODS: We propose to conduct a prospective, single-center, randomized, positive parallel controlled, non-inferiority, clinical trial at Shiyan Taihe Hospital, China. Seventy-two patients with knee disease who are scheduled to undergo knee arthroplasty will be equally randomized into the trial group or the control group using a randomized block design. The trial and control groups will undergo knee arthroplasty with knee prostheses purchased from Wuhan Yijiabao Biomaterial Co., Ltd., Wuhan, China (newly developed) and Beijing AKEC Medical Co., Ltd., Beijing, China (approved by the China Food and Drug Administration), respectively. All patients will be followed up for 12 months. The primary outcome will be the recovery of knee function as assessed by the rate of excellent and good Hospital for Special Surgery knee scores at postoperative 12 months (± 15 days). The secondary outcomes will be: the morphology of the knee as revealed by anteroposterior and lateral radiographic views taken preoperatively, and at postoperative 2 weeks (± 5 days), 6 weeks (± 15 days), 3 months (± 15 days), 6 months (± 15 days), and 12 months (± 15 days); the incidence of adverse reactions at postoperative 2 weeks (± 5 days), 6 weeks (± 15 days), 3 months (± 15 days), 6 months (± 15 days), and 12 months (± 15 days); and the correlation between various types of adverse reactions and each knee prosthesis type. This trial has been registered at ClinicalTrials.gov (identifier: 03184129). The study protocol has been approved by the Ethics Committee of Taihe Hospital of China (approval number: 2016 (34)). All protocols will be performed in accordance with the Ethical Principles for Medical Research Involving Human Subjects in the Declaration of Helsinki. Written informed consent was provided by each patient and their family members after they indicated that they fully understood the treatment plan.
    DISCUSSION: Participant recruitment began in February 2017 and will be finished in September 2017. Data analysis will be completed in November 2018. Wuhan Yijiabao Biomaterial Co., Ltd. has developed a new knee prosthesis system. This system uses cobalt-chrome-molybdenum and high cross-linked polyethylene as the active friction interface, which has excellent wear resistance. This trial is designed to verify the efficacy and safety of this novel knee prosthesis in total knee arthroplasty.

     
    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Biomechanics characteristics of calcar reconstruction using different methods in senile intertrochanteric fractures  
    Hou Li-gang
    2017, 21 (23):  3616-3621.  doi: 10.3969/j.issn.2095-4344.2017.23.002
    Abstract ( 550 )   PDF (1003KB) ( 190 )   Save

    BACKGROUND: Calcar plays an important role in hip arthroplasty. The reconstruction of calcar includes bone cement reconstruction and restoration of fracture fragments, but there is some lack of knowledge about their comparative study.

    OBJECTIVE: To analyze the biomechanical characteristics of remodeled calcar using bone cement reconstruction and restoration of fracture fragments in senile intertrochanteric fractures through three-dimensional finite element models.
    METHODS: The remodeled calcar using restoration of fracture fragments (model A) or bone cement reconstruction (model B) in senile intertrochanteric fractures was obtained. The stress distribution on the bone interface and prosthesis, the overall stress and displacement of the two models were observed.
    RESULTS AND CONCLUSION: (1) The maximal strain and stress on the bone interface and prosthesis of model A all were more than those of model B. The mean stresses at each node on the bone interface and prosthesis of model A all were significantly higher than those of model B (P < 0.05). (2) The maximum stress and maximum displacement values of the model A all were higher than those of model B. (3) These results show that the maximal stress and displacement values of the remodeled calcar using restoration of fracture fragments are higher than those of bone cement reconstruction in senile intertrochanteric fractures; the latter holds even stress distribution and better repair outcomes.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Cemented versus uncemented hemiarthroplasty for unstable intertrochanteric fractures in the elderly
    Jiang Hai-liang, Guo Kai-jin, Wang Xiang, Li Jie
    2017, 21 (23):  3622-3627.  doi: 10.3969/j.issn.2095-4344.2017.23.003
    Abstract ( 370 )   PDF (1019KB) ( 241 )   Save

    BACKGROUND: The use of cemented or uncemented hemiarthroplasty for unstable intertrochanteric fractures in the elderly remains controversial. Therefore, it is necessary to conduct a comparative study on the effectiveness and safety of these two methods.

    OBJECTIVE: To compare the clinical efficacy of cemented and uncemented hemiarthroplasty for unstable intertrochanteric fractures in the elderly.
    METHODS: Clinical data of 93 elderly patients with unstable intertrochanteric fractures in Department of Orthopedics, Shandong Energy Zaozhuang Mining Group General Hospital from May 2009 to May 2014 were analyzed retrospectively. All patients were divided into cemented (cemented bipolar hemiarthroplasty for fractures, n=54) and uncemented (uncemented bipolar hemiarthroplasty for fractures, n=39) groups.
    RESULTS AND CONCLUSION: (1) The amounts of postoperative drainage and blood transfusion in the cemented group were significantly less than those in the uncemented group (P < 0.05), but the operation time was significantly longer (P < 0.05). (2) There were no significant differences in the intraoperative blood loss, ambulation time, hospitalization time, postoperative complications, hip function, and mortality at 3 and 12 months postoperatively between two groups (P > 0.05). (3) Postoperative X-ray showed that all patients had good prosthesis position. There were 10 patients (3 cases in the cemented group, 7 cases in the uncemented group) with postoperative prosthesis subsidence, but all of them were less than 3 mm. (4) None of patients had heterotopic ossification, osteolysis around the prosthesis and acetabular cartilage wear during follow-up. Additionally, 25 patients (16 cases in the cement group, 9 cases in the uncement group) died during follow-up, without prosthesis loosening, and the remaining 68 patients were followed up for 2-7 years, (4.5±2.3) years on average, and none needed revision because of prosthesis loosening. (5) These results indicate that for senile unstable intertrochanteric fractures, both cemented and uncemented hemiarthroplasty can achieve satisfactory curative effectiveness and exhibits good safety. Notably, the cemented prosthesis has advantages in reducing postoperative drainage volume and blood transfusion.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Drainage at different time points after tranexamic acid administration in total hip arthroplasty: a retrospective study
    Hao Shen-shen, Liu Yan-xiong, Liu Zhi-bin
    2017, 21 (23):  3628-3633.  doi: 10.3969/j.issn.2095-4344.2017.23.004
    Abstract ( 414 )   PDF (1021KB) ( 229 )   Save

    BACKGROUND: Topical tranexamic acid (TXA) administration has been described to be effective in decreasing blood loss in total hip arthroplasty (THA). Most of research focus on the postoperative total drainage, but the drainage at different time points after replacement is little reported.

    OBJECTIVE: To investigate the effect of topical TXA on the volume of drainage at different time points after THA.
    METHODS: Data of 79 cases of primary unilateral THA were analyzed retrospectively, and allotted to two groups. TXA group (n=38) was subjected to the reverse perfusion of 1.5 g of TXA (50 mL) by drainage tube after THA, and control group (n=41) was given 50 mL of normal saline in the same way. The postoperative drainage at 1, 2 and 3 days, total postoperative drainage, and hemoglobin level at postoperative 3 days were collected and compared between two groups.
    RESULTS AND CONCLUSION: There was no significant difference in the baseline data between two groups (P > 0.05). (1) The postoperative drainage at 1 day and total drainage in the TXA group was significantly lower than that in the control group, and the drainage showed no significant difference at postoperative 2 and 3 days between two groups (P > 0.05). (2) The hemoglobin level was significantly increased in the TXA group compared with the control group at 3 days postoperatively (P < 0.05). (3) To conclude, the topical TXA administration can reduce the postoperative drainage in primary unilateral THA, especially at the first day.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Accolade II short stem for Crowe type I developmental dysplasia of the hip in adults
    Ning Xin-chuang, Ni Ming, Fan Li-zhong, Chen Ji-ying, Chen Gui-yue, Guo Jia-bin, Li Xin, Liu Kan
    2017, 21 (23):  3634-3639.  doi: 10.3969/j.issn.2095-4344.2017.23.005
    Abstract ( 571 )   PDF (1321KB) ( 258 )   Save

    BACKGROUND: Compared with the cone stem, short stem holds good matching with femoral canal, and remarkably reduces the risk of prosthesis loosening.

    OBJECTIVE: To further investigate the clinical efficacy of Accolade II stem for Crowe type I developmental dysplasia of the hip.
    METHODS: Clinical data of 16 patients with Crowe type I developmental dysplasia of the hip undergoing total hip arthroplasty using Accolade II stem were collected, the length of both lower limbs before and after surgery was compared, and the Visual Analogue Scale, functional recovery of the hip and general conditions were observed at 12 weeks postoperatively. 
    RESULTS AND CONCLUSION: (1) The change in length of both lower limbs before and after surgery had significant difference (P < 0.05), and 10 patients (62%) with the same length of both lower limbs before surgery, and 15 cases (94%) after surgery. (2) The postoperative acetablar abducent angle was 41°-54° (average 46.9°). (3) The Visual Analogue Scale and Harris hip scores after surgery were significantly improved compared with baseline (P < 0.05). (4) The intraoperative blood loss was 147 mL on average, the mean operation time was 72 minutes, and the hospitalization time was 7.2 days. (5) All patients recovered well and no complications occurred at 3 months postoperatively. (6) To conclude, Accolade II stem is safe and reliable for Crowe type I developmental dysplasia of the hip, and exhibits good functional recovery of the hip.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Reversion after total hip arthroplasty: a follow-up of 85 cases
    Li Hui-jie, Bao Jie, Gao Zi-mei
    2017, 21 (23):  3640-3645.  doi: 10.3969/j.issn.2095-4344.2017.23.006
    Abstract ( 542 )   PDF (2764KB) ( 246 )   Save

    BACKGROUND: With the prevalence of total hip arthroplasty, the demand for revision has been increased due to the prosthesis life and various complications.

    OBJECTIVE: To retrospectively analyze the reasons and clinical effectiveness of revision, clinical application of revision prosthesis, and related revision techniques.
    METHODS: Clinical data of 85 patients undergoing total hip revision were analyzed retrospectively. Among which, there were 23 cases of biological T.O.P acetabular cup (allograft bone graft) plus polyethylene liner, 51 cases of titanium mesh cup plus bone cement fixation, and 11 cases of common acetabular cup; common hip stem in 63 cases (including 47 cases of bone cement fixation); lengthened hip stem in 34 cases (16 cases of modular prosthesis and 18 cases of bone cement fixation). Subsequently, the hip function was assessed by Harris hip scores.
    RESULTS AND CONCLUSION: All cases were followed up, and the mean follow-up was 30.2 months. (1) The average Harris hip scores changed from preoperative 30.07 to postoperative 90.32. The wound healed well, no dislocation or infection, and the hip function was improved significantly. (2) To conclude, aseptic loosening of the prosthesis is the main cause of reversion occurred, followed by prosthesis dislocation. Acetabular wall bone defect and decrease in bone mass are the main problems in revision. Adequate preoperative preparation for possible and unexpected events, and reasonable selection of prosthesis according to the bone defects will be helpful. Noticeably, early arthroplasty reversion will obtain good clinical efficacy.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Analgesic effect of periarticular multimodal drug injection versus nerve block in total knee arthroplasty  
    Zhu Xian-yang, Yin Zong-sheng, Lu Ming, Jiang Zheng
    2017, 21 (23):  3646-3651.  doi: 10.3969/j.issn.2095-4344.2017.23.007
    Abstract ( 521 )   PDF (1116KB) ( 220 )   Save

    BACKGROUND: Periarticular multimodal drug cocktail injection for pain management after total knee arthroplasty (TKA) has been reported, but there are few studies concerning its effect on the range of motion and volume of drainage postoperative, and difference to nerve block.

    OBJECTIVE: To compare the analgesic effect of periarticular multimodal drug injection and nerve block in TKA.
    METHODS: Fifty-eight patients undergoing primary unilateral TKA in the First Affiliated Hospital of Anhui Medical University from 1 June 2016 to 31 October 2016 were randomly assigned to experimental and control groups (n=29 per group), followed by received a periarticular intraoperative injection of a 100 mL mixture containing ropivacaine, epinephrine, morphine, and normal saline, and preoperative combined femoral and sciatic nerve block, respectively. Subsequently, the Visual Analogue Scale scores, and range of motion, volume of drainage, hospitalization time, number of the patients given remedial analgesia and complications were compared between two groups.
    RESULTS AND CONCLUSION: (1) The Visual Analogue Scale scores at rest in the experimental group were significantly lower than those in the control group at 3 days after surgery (P < 0.05). (2) The Visual Analogue Scale scores on movement in the experimental group were significantly lower than those in the control group at 1, 2 and 3 days after surgery (P < 0.05). (3) There were no significant differences in the range of motion, volume of drainage, hospitalization time and number of the patients give remedial analgesia between two groups postoperatively (P > 0.05). (4) None appeared with obvious nausea, vomiting and other complications in the two groups. (5) These results indicate that the analgesic effect of periarticular multimodal drug injection is superior to nerve block, and the former is easy to operate, economical and practical.
     
    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Effect of perioperative temperature protection on the coagulation function during total knee arthroplasty  
    Si Jian-luo, Yang Mu-qiang, Zhang Li-yuan, Sima Liang-jie, Dong Xu
    2017, 21 (23):  3652-3657.  doi: 10.3969/j.issn.2095-4344.2017.23.008
    Abstract ( 545 )   PDF (1117KB) ( 295 )   Save

    BACKGROUND: Perioperative hypothermia may lead to coagulation function for patients undergoing total knee arthroplasty, and an increase in blood loss.

    OBJECTIVE: To compare the influence of temperature protection with non-temperature protection on coagulation function in patients undergoing total knee arthroplasty.
    METHODS: Forty ASA I-II patients scheduled for total knee arthroplasty were randomly divided into temperature protection and non-temperature protection groups (n=20 per group). The patients in the temperature protection group underwent heat-preservation including preheating room temperature, actively blanket warmer, were infused or flushed with fluids of 37 by heating apparatus; the patients in the non-temperature protection group received full-body-covered cotton quilt only. The nasopharyngeal temperature were detected at postoperative 10 minutes, intraoperative 1 hour and postoperative 1 hour, and 1.25 mL of venous blood were collected to detect the fibrin formation time, blood clot formation time, and maximum amplitude using thrombelastography. Additionally, the intraoperative blood loss and volume of drainage at postoperative 24 hours were recorded.
    RESULTS AND CONCLUSION: (1) The nasopharyngeal temperature in the non-temperature protection group was significantly lower than that in the temperature protection group at postoperative 1 hour (P < 0.05). (2) The intraoperative blood loss and volume of drainage at postoperative 24 hours in the temperature protection group were significantly less than those in the non-temperature protection group (P < 0.05). (3) Compared with the temperature protection group, fibrin formation time and blood clot formation time at intraoperative and postoperative 1 hour were significantly lengthened, and maximum amplitude at postoperative 1 hour was significantly shortened in the non-temperature protection group (P < 0.05). (4) These findings show that intraoperative hypothermia can weaken platelet function, inhibit coagulation factor activity, and increase the amount of blood loss and drainage. In the meanwhile, heat-preservation is able to reduce the loss of body heat, improve coagulation function and reduce blood loss for patients undergoing knee replacement.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Cognitive behavior therapy alleviates kinesiophobia after total knee arthroplasty  
    Cai Li-bai, Liu Yan-jin, Zhao Hui, Xu Hui-ping, Gao Huan-huan, Dong Yue-zhi
    2017, 21 (23):  3658-3663.  doi: 10.3969/j.issn.2095-4344.2017.23.009
    Abstract ( 1286 )   PDF (1110KB) ( 690 )   Save

    BACKGROUND: Early rehabilitation after total knee arthroplasty (TKA) can help the rapid functional recovery of knee, but some patients are fear of moving and refuse to do exercising because of kinesiophobia, thereby delaying functional recovery. Foreign study has confirmed that patients with cognitive behavioral therapy (CBT) can effectively alleviate kinesiophobia, but no related studies have been reported in China.

    OBJECTIVE: To explore the effectiveness of CBT on patients with kinesiophobia after TKA.
    METHODS: 108 patients with kinesiophobia after TKA were recruited from Department of Orthopedics, the First Affiliated Hospital of Zhengzhou University, China between March 2014 and January 2015, and were then equivalently randomized into experimental and control groups using random number table. Both groups were subjected to conventional treatment, while the experimental group received extra CBT. The scores of Tampa Scale of Kinesiophobia and American Knee Society were evaluated immediately, 1, 3, and 6 months after hospital discharge; the hospitalization time and total hospitalization expenditure were compared between two groups immediately after discharge.
    RESULTS AND CONCLUSION: The scores of Tampa Scale of Kinesiophobia in the experimental group were significantly lower than those in the control group at different time points postoperatively (P < 0.05). The scores of American Knee Society in the experimental group were significantly higher than those in the control group at 3 and 6 months after discharge and kept on rising (P < 0.01), but showed no significant difference at discharge and 1 month after discharge (P > 0.05). (2) The hospitalization time and total hospitalization expenditure in the experimental group were significantly lower than those in the control group (P < 0.01). (3) To conclude, CBT cannot only shorten the hospitalization time and total hospitalization expenditure, but also relieve kinesiophobia, which is conductive for functional recovery of the knee.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Percutaneous pedicle screw fixation combined with calcium sulfate cement for single-level thoracolumbar fracture: a 3-month follow-up  
    Zhan Fang-biao, Cheng Jun, Feng Shi-long, Xie Li-zhong, Li Bo, Zhang You, Chen Lin
    2017, 21 (23):  3664-3669.  doi: 10.3969/j.issn.2095-4344.2017.23.010
    Abstract ( 562 )   PDF (1156KB) ( 180 )   Save

    BACKGROUND: Percutaneous pedicle screw fixation has been applied in the treatment of thoracolumbar fracture, and has achieved satisfactory clinical efficacy. Injectable calcium sulfate holds good biocompatibility, degradability and fast curing.

    OBJECTIVE: To explore the clinical efficacy of percutaneous pedicle screw fixation combined with calcium sulfate cement for single-level thoracolumbar fracture.
    METHODS: Clinical data of 40 patients with single-level thoracolumbar fracture without nerve injury were analyzed retrospectively. All fractured vertebrae were compressed more than 30% and at least one pedicle was complete. All patients were treated with percutaneous pedicle screw fixation combined with calcium sulfate cement. The Visual Analog Scale and Oswestry Disability Index scores were recorded at baseline, 3 months postoperatively and last follow-up; the height of the fractured vertebra body and sagittal Cobb angle were measured on X-ray; the patient’s satisfaction and healing rate were recorded.
    RESULTS AND CONCLUSION: (1) The Oswestry Disability Index at 3 months postoperatively and last follow-up was 16.3% and 4.4%, respectively. Compared with baseline, the Cobb angle and Visual Analog Scale scores were significantly reduced, and height of the fractured vertebra body was significantly increased after surgery (P < 0.01). (3) The healing rate at last follow-up was 95%, nonunion was not found, and the patients’ satisfaction reached 95%. (4) The loss of vertebral height and Cobb angle was found at last follow-up compared with 3 months postoperatively, but had no significant difference (P > 0.05). (5) These results indicate that percutaneous pedicle screw fixation combined with calcium sulfate cement is safe and reliable for single-level thoraclumbar fracture, which not only restores the vertebral height and relieves pain, but also has satisfactory long-term curative efficacy and high healing rate.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Percutaneous vertebroplasty combined with granulated allogeneic bone grafting for thoracolumbar compressive fractures: the completeness and stability of fractured vertebrae  
    Lin Yu-jiang, Yang Li-min, Yang Jian
    2017, 21 (23):  3670-3675.  doi: 10.3969/j.issn.2095-4344.2017.23.011
    Abstract ( 529 )   PDF (1420KB) ( 329 )   Save

    BACKGROUND: Percutaneous vertebroplasty is mainly used to treat senile osteoporotic compressive fractures, while for young patients, pedicle screw internal fixation is usually applied, but heavy trauma, nail broken, secondary surgery and other problems can be found occasionally. 

    OBJECTIVE: To investigate the clinical efficacy of percutaneous vertebroplasty combined with granulated allogeneic bone grafting for thoracolumbar compressive fractures. 
    METHODS: Twenty-one patients suffering thoracolumbar compressive fractures were recruited, and underwent percutaneous vertebroplasty combined with granulated allogeneic bone grafting. The Visual Analogue Scale scores, height ratio of fractured vertebrae and Cobb angle were detected before and after surgery. 
    RESULTS AND CONCLUSION: (1) Compared with baseline, the Visual Analogue Scale scores were improved significantly at 1 day and 6 months postoperatively (P < 0.05). (2) The height ratio of fractured vertebrae at 1 day and 6 months postoperatively was significantly higher than that before treatment (P < 0.05). (3) The Cobb angle of fractured vertebrae at 1 day and 6 months postoperatively was significantly less than that before treatment (P < 0.05). (4) The mean operation time was (52±12.3) minutes, and the mean blood loss was (11.5±1.5) mL. (5) These results suggest that percutaneous vertebroplasty combined with granulated allogeneic bone grafting can effectively restore the anterior fractured vertebral height, eliminate the cavity in the fractured vertebrae, renew the completeness and stabilization of the fractured vertebrae, which keep the spinal range of motion; therefore, it is a minimal invasive method in the treatment of thoracolumbar fractures. 

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Biomechanical properties of hyperextension traction-elastic compression combined with percutaneous pedicle screw fixation for thoracolumbar fractures  
    Feng Hua-long, Lai Ju-yi, Huang Fei-qiang
    2017, 21 (23):  3676-3681.  doi: 10.3969/j.issn.2095-4344.2017.23.012
    Abstract ( 383 )   PDF (1252KB) ( 207 )   Save

    BACKGROUND: The traditional percutaneous pedicle screw fixation for thoracolumbar fractures has a lot of shortcomings, such as restoring the vertebral height. The combination of hyperextension traction-elastic compression and internal percutaneous pedicle screw fixation provides a new treatment strategy.

    OBJECTIVE: To observe and compare the biomechanical properties of the traditional percutaneous transpedicular screw fixation and hyperextension traction-elastic compression combined with percutaneous pedicle screw fixation in the treatment of thoracolumbar fractures.
    METHODS: Clinical data of 40 patients with simple vertebral compression fractures undergoing traditional percutaneous pedicle screw fixation (control group) or hyperextension traction-elastic compression combined with percutaneous pedicle screw fixation (treatment group) were analyzed retrospectively, and none had neurologic signs or symptoms. The operation time, intraoperative radiant volume, intraoperative blood loss, hospitalization time or complications were compared between two groups. The sagittal Cobb angle and percentage of anterior height in vertebral body were measured at baseline and different time points after internal fixation. The pain and symptom improvement were evaluated by Visual Analogue Scale and Oswestry Disability Index.
    RESULTS AND CONCLUSION: All patients were followed up for 12 months. (1) There were no significant differences in the operation time, intraoperative radiation volume, intraoperative blood loss, hospitalization time and complications between two groups (P > 0.05). (2) The sagittal Cobb angle, percentage of anterior height in vertebral body, Visual Analogue Scale and Oswestry Disability Index scores after internal fixation were significantly superior to those before internal fixation in both two groups (P < 0.05). (3) The sagittal Cobb angle and percentage of anterior height in vertebral body in the treatment group were significantly superior to those in the control group at 24 hours, 6 and 12 months postoperatively (P < 0.05). (4) The Visual Analogue Scale and Oswestry Disability Index scores in the treatment group were significantly superior to those in the control group at 12 months postoperatively (P < 0.05). (5) These results indicate that hyperextension traction-elastic compression combined with percutaneous pedicle screw fixation exerts remarkable effect on restoring the vertebral height and effectiveness compared with the traditional percutaneous pedicle screw fixation.

     
    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Posterior lumbar interbody fusion plus screw implantation with posterior ligamentous complexes under microscope for lumbar degenerative disease  
    Ji Jing-tao, Miao Jun, Li Wen-jun, Zhu Shan
    2017, 21 (23):  3682-3687.  doi: 10.3969/j.issn.2095-4344.2017.23.013
    Abstract ( 475 )   PDF (1247KB) ( 183 )   Save

    BACKGROUND: Removing the posterior ligamentous complexes during posterior lumbar interbody fusion (PLIF) may influence motion and load bearing characteristics of the adjacent segments, contributing to the postoperative instability at the adjacent segment, which is one of the important factors for adjacent segment degeneration.

    OBJECTIVE: To evaluate the clinical effectiveness of the PLIF plus screw implantation preserving posterior ligamentous complexes under microscope.
    METHODS: Thirty-six patients with single-level lumbar degenerative disease were enrolled, which were allotted to experimental (n=17) and control (n=19) groups, followed by treated with PLIF plus screw implantation preserving posterior ligamentous complexes, and traditional PLIF plus screw implnatation, respectively. The Visual Analogue Scale scores and Oswestry Dysfunction Index at baseline and postoperative 3 months were assessed. The adjacent segment degeneration was observed through radiology during follow-up.
    RESULTS AND CONCLUSION: The Visual Analogue Scale and Oswestry Dysfunction Index scores in the two groups were significantly lower than those before treatment (P < 0.01), and the postoperative scores in the experimental group were significantly lower than those in the control group (P < 0.01). The adjacent segment degeneration occurred in two cases in the experimental group and 8 cases in the control group during follow-up. Radiology revealed that the internal fixative was stable, none of screw loosening, rupture or pullout. These results suggest that PLIF plus screw implantation with posterior ligamentous complexes can effectively relieve the pain and dysfunction in the lumbar degenerative patients, and reduce the incidence of adjacent segment degeneration. 

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Pedicle screw fixation combined with posterior lumbar interbody fusion for degenerative lumbar spondylolisthesis in the elderly
    Chen Kang-wu, Zhang Kai, Chen Hao, Wang Gen-lin, Zhu Xiao-yu, Qian Zhong-lai, Yang Hui-lin
    2017, 21 (23):  3688-3693.  doi: 10.3969/j.issn.2095-4344.2017.23.014
    Abstract ( 695 )   PDF (1186KB) ( 268 )   Save

    BACKGROUND: Whether lumbar spondylolisthesis needs to be treated with reduction remains controversial.

    OBJECTIVE: To investigate the clinical effectiveness of pedicle screw fixation combined with posterior lumbar interbody fusion for degenerative lumbar spondylolisthesis in the patients aged more than 70 years old.
    METHODS: The clinical data of 30 patients with degenerative spondylolisthesis aged over 70 years old undergoing pedicle screw fixation combined with posterior lumbar interbody fusion were analyzed retrospectively. The Visual Analogue Scale, Oswestry Dysfunction Index and the Japan Orthopedics Association scores were compared and analyzed before and after surgery.
    RESULTS AND CONCLUSION: (1) Among 30 patients, 12 were male and 18 female, the average age was (75.1±6.7) years old, and all were followed up for more than 12 months. (2) The postoperative Visual Analogue Scale, Oswestry Dysfunction Index and the Japan Orthopedics Association scores were significantly improved compared with baseline (P < 0.05). According to the Japan Orthopedics Association scores, 3 cases were cured, 24 were significantly effective, and 3 effective. (3) Graft fusion was achieved at all patients, the average fusion time was (5.13±0.65) months. (4) The average operation time was (225.6±23.4) minutes, the average intraoperative blood loss was (470±45.5) mL, and the average follow-up time was (25.8±3.5) months. (5) Six patients presented complications (20%), including one case of dural tear, two cases of paralytic intestinal obstruction, and three transient lower extremity nerve symptoms. (6) These results indicate that if the associated disorders are strictly controlled, pedicle screw fixation combined with posterior lumbar interbody fusion can achieve good surgical results in the treatment of degenerative spondylolisthesis in the elderly.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Diagnosis and prevention of deep vein thrombosis after spine surgery in the elderly  
    Yang Li-yong, Ma Hai-gang, Li Zhen, Zao Dong-yang, Zhang Ji
    2017, 21 (23):  3694-3699.  doi: 10.3969/j.issn.2095-4344.2017.23.015
    Abstract ( 518 )   PDF (966KB) ( 256 )   Save

    BACKGROUND: Deep vein thrombosis is a common complication following bone surgeries, so its prevention and treatment become critical. However, there are few studies on the incidence of deep vein thrombosis after spine surgery in the elderly.

    OBJECTIVE: To explore the diagnosis of deep vein thrombosis after spine surgery in the elderly and its incidence after intervention with low-molecular-weight heparin.
    METHODS: All patients undergoing spine surgery were randomly divided into experimental and control groups. Patients in the experimental group were subjected to the subcutaneous injection of 0.4 mL of low-molecular-weight heparin (4 100 IU) at 12 hours postoperatively, once daily for 7-14 days from the next day. Those received no intervention served as controls. The thromboplastin time, thrombin time, activated partial thromboplastin time, and level of plasma fibrinogen were detected before and after treatment. Color Doppler ultrasound results of the lower extremity vessel before and after treatment and postoperative drainage volume were recorded.

    RESULTS AND CONCLUSION: (1) In the experimental group, the lower level of plasma fibrinogen and slightly prolonged thromboplastin time, thrombin time and activated partial thromboplastin time were observed, but all were within the normal range. (2) The incidence of deep vein thrombosis in the experimental group (0%) was significantly lower than that in the control group (5%, P < 0.05). (3) To conclude, low-molecular-weight heparin therapy significantly reduced the incidence of deep vein thrombosis after spine surgery.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程

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    Bending strength and stress distribution of the interlocking intramedullary nails with high-thread wooden club-shaped nails versus traditional nails
    Xia Guan-ping, Wang Yong-qing, Dong Li-min, Liu Lei, Dong Yan-sheng, Wang Ye-lin
    2017, 21 (23):  3700-3705.  doi: 10.3969/j.issn.2095-4344.2017.23.016
    Abstract ( 403 )   PDF (1282KB) ( 218 )   Save

    BACKGROUND: Interlocking intramedullary nailing is a main method for bone fractures, but traditional static intramedullary nails usually lead to nail breakage and loosening. Thereafter, we design a novel high-thread wooden club-shaped screw (HTWCSS) and explore its mechanical properties.

    OBJECTIVE: To measure the bend strengths of HTWCSS, analyze its stress distribution, and to evaluate its biomechanical properties, thereby providing theoretical basis for its clinical application.
    METHODS: The bend strength of HTWCSS and traditional nails were measured via three-point bending experiments. Transverse fractures of the middle tibia were simulated using finite element method, and then the force and stress distribution of the two different nails were analyzed.
    RESULTS AND CONCLUSION: (1) The average maximum load of HTWCSS was 3.52 kN and 1.81 kN at span of 20 mm and 30 mm, respectively, which were larger than those of the traditional nails. (2) The average maximum displacement and the stress of HTWCSS were smaller than those of the traditional screws in finite element analysis, and the stress distribution was relatively dispersed. (3) The average maximum axial displacement and stress HTWCSS, traditional interlocking screws, wooden club-shaped screws and traditional screws were 131 MPa and 3.27 mm, 162 MPa and 4.07 mm, 26.5 MPa and 0.323 mm, and 34.3 MPa and 0.407 mm, respectively. (4) These results suggest that HTWCSS has relative high bend strength, and it is able to disperse stress and improve fatigue strength bend strength, further reduce screw broken. 

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Safety and effectiveness of the reversed Less Invasive Stabilization System plates for elderly patients with femoral intertrochanteric fractures  
    Wei Xing, Zou Yong-gen
    2017, 21 (23):  3706-3711.  doi: 10.3969/j.issn.2095-4344.2017.23.017
    Abstract ( 491 )   PDF (966KB) ( 222 )   Save

    BACKGROUND: Less Invasive Stabilization System (LISS) has been shown to hold the same biomechanical strength to proximal femoral nail anti-rotation.

    OBEJCTIVE: To investigate the safety and effectiveness of the reversed LISS plates for senile femoral intertrochanteric fractures.
    METHODS: Thirty elderly patients with femoral intertrochanteric fractures were treated with reversed LISS plates. The operation time, incision length and total blood loss (intraoperative plus volume of drainage 1 day postoperative) were recorded. Physiologic and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) and modified POSSUM scoring systems were used to predict the incidence of complications and mortality, and then the real incidence of complication and mortality was compared to evaluate the safety of reversed LISS plates. The clinical effectiveness was evaluated by fracture healing time and Harris scores at the last follow-up.
    RESULTS AND CONCLUSION: (1) The incidence of complications showed significant difference between predicted (46.05%) and real (13.3%) results (P=0.05), but the mortality did not differ significantly between predicted (3.93%) and real (0%) results (P=1). (2) The fracture healing time was 21-32 weeks, and the excellent and good rate in Harris scores at the last follow-up was 83.3%. (3) These results indicate that the reversed LISS plates are easy to operate, safe and obtain good efficacy in the treatment of senile femoral intertrochanteric fractures. 

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Mechanical analysis of the distal tibia posterior locking plate fixation for posterior Pilon fracture  
    Gao Yang, Zhang De-qiang, Tang Xin
    2017, 21 (23):  3712-3717.  doi: 10.3969/j.issn.2095-4344.2017.23.018
    Abstract ( 380 )   PDF (1122KB) ( 219 )   Save

    BACKGROUND: Open reduction and internal fixation has been confirmed to treat posterior Pilon fracture, but choosing which fixation scheme is still under discussion.

    OBJECTIVE: To explore the biomechanical properties of posterior Pilon fracture after repaired by two different fixation methods, thus providing reference for selecting an appropriate fixation scheme.
    METHODS: Twenty right artificial femurs were randomized into two groups A and B, and the models of posterior Pilon fracture were established based on its characters and classification. The group A received with 5 holes distal tibial posterior locking plate fixation, and the group B underwent two 3.5 mm of cortical screws from back to front bicortical fixation, followed by placed in the InstronElectroPulsE3000 universal electronic static and dynamic materials testing systems, vertical speed loaded until internal fixation failure, the loading was recorded when different steps appeared.
    RESULTS AND CONCLUSION: (1) After loading, none of groups presented with screw bent or broken. (2) The axial load when appeared with 0.5, 1.0, 1.5, and 2.0 mm steps in the group A was higher than that in the group B, and the axial load significantly increased with fracture fragment displacement increasing (P < 0.05). (3) The biomechanical test shows that the distal tibial posterior locking plate fixation is better than screws in the treatment of posterior Pilon fracture.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Photoelectric navigation-aided percutaneous pedicle screw placement versus traditional open posterior pedicle screw fixation for thoracolumbar fractures  
    Zhong Ze-li, Wan Sheng-yu, Tan Lun, Lin Xu, Wu Chao
    2017, 21 (23):  3718-3723.  doi: 10.3969/j.issn.2095-4344.2017.23.019
    Abstract ( 402 )   PDF (1134KB) ( 233 )   Save

    BACKGROUND: Photoelectric navigation-aided percutaneous pedicle screw placement has been developed extensively, but its accuracy, safety and effectiveness have not yet been confirmed by evidence-based medicine.

    OBJECTIVE: To compare the curative efficacy of photoelectric navigation-aided percutaneous pedicle screw placement and traditional open posterior pedicle screw fixation for thoracolumbar fractures.
    METHODS: Sixty patients with thoracolumbar fractures were equivalently randomized to treatment and control groups and then underwent photoelectric navigation-aided percutaneous pedicle screw placement and traditional open posterior pedicle screw fixation, respectively. The perioperative indexes, imaging indexes, function recovery and incidence of complications were compared between two groups.
    RESULTS AND CONCLUSION: (1) The Visual Analogue Scale scores, intraoperative blood loss, radiant times, and hospitalization time in the treatment group were significantly less than those in the control group (P < 0.05). (2) The operation time did not differ significantly between two groups (P > 0.05). (3) The postoperative sagittal Cobb angle, and percentage of anterior height in the vertebral body in the two groups were significantly improved compared with those before surgery (P < 0.05), but all above imaging indexes showed no significant differences between two groups (P > 0.05). The endplate-screw angle in the treatment group was significantly less than that in the control group (P < 0.05). (5) The excellent and good rate of placement in the treatment group was significantly higher than that in the control group  (P < 0.05). (6) These results suggest that compared with the traditional open posterior pedicle screw fixation, the photoelectric navigation-aided percutaneous pedicle screw placement exhibits high placement accuracy, less radiant times, less trauma, less blood loss and rapid functional recovery.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Design of the three-dimensional-printed individualized pedicle guide plate and its accuracy of placement  
    Xu Ke, Pu Xiao-peng, Zheng Wang, Zhang Long, Huang Teng, Meng Fan-tao, Li Xi-cheng
    2017, 21 (23):  3724-3729.  doi: 10.3969/j.issn.2095-4344.2017.23.020
    Abstract ( 495 )   PDF (3345KB) ( 243 )   Save

    BACKGROUND: Surgical accuracy is a key to surgical success. The traditional positioning method mainly depends on surgeons’ experience, which is too subjective to cause screw misplacement. Three-dimensional (3D) printing technology-assisted pedicle screw placement can make individualized surgical scheme, most importantly, it is accurate and simple showing promising application prospect.

    OBJECTIVE: To design an individualized pedicle guide plate with 3D printing and to simulate screw placement in vitro, and to explore its feasibility in vertebral pedicle screw placement.
    METHODS: Lumbar spine CT data of 11 patients with degenerative lumbar spine were selected from April 2016 to July 2016 at Hebei General Hospital, and 3D reconstruction of L1, L3 and L5 vertebrae of each case was performed. Pre-experiment was conducted based on one patient’s lumbar CT data: according to the principle of screw placement, the screw position and orientation were designed to prepare the best pedicle guide plate model. Afterwards, the screw placement in vitro was simulated, and was then cut by chainsaw to verify the accuracy of screw placement.
    RESULTS AND CONCLUSION: (1) A total of 30 pedicle guide plates were used, and 60 screws were inserted in the patients, and the placement process was successful. The guide plates adhered well, none appeared with screw perforating the pedicle cortex, and the screw position was accurate and reliable. (2) There were no significant changes in the transverse section and sagtial section angles of the left and right pedicle screws before and after placement (P > 0.05). (3) These results suggest that the 3D-printed individualized pedicle guide plate holds a good accuracy of placement, which can be applied in the vertebral pedicle screw placement, but further clinical trials are needed.

     
    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Plantar pressure of normal people with different body mass index
    Zhong Hui-min, Huang Ping
    2017, 21 (23):  3730-3735.  doi: 10.3969/j.issn.2095-4344.2017.23.021
    Abstract ( 646 )   PDF (1709KB) ( 213 )   Save

    BACKGROUND: Body mass is a critical factor affecting plantar pressure, and the systematic study on plantar pressure with different body mass has not been reported.

    OBJECTIVE: To measure the plantar pressure of normal people with different body weight, so as to provide reference for the application of plantar pressure.
    METHODS: Totally 80 healthy people with different body weight were enrolled, and the dynamic plantar pressure was measured by the Footscan 2 meter flat foot pressure distribution system (RSscan, Belgium). The participants were divided into four groups (n=20 per group) according to the classification criteria for prevention and control of overweight and obesity in Chinese adults, such as underweight, normal weight, overweight group, and obesity groups, and a comparative analysis was conducted.
    RESULTS AND CONCLUSION: (1) The peak pressure and impulse of each region of the foot were significantly increased with body mass index increasing (P < 0.05). Compared with the normal weight people, the pressure of the part foot area of the overweight subjects and each part foot area of the obese subjects were significantly increased (P < 0.05). (2) The percentage of the medial plantar contact area accounting the total contact area of the foot was significantly increased with body mass index increasing (P < 0.01); the percentage in the obese group was significantly higher than that in the normal group (P < 0.05). (3) These results show that the plantar pressure and impulse are increased in overweight and obese subjects due to weight gain, and foot will appear with pathological changes with time going. Obese people suffer from arch drop due to weight gain, and increase in contact area of midfoot, which are easy to cause flatfoot. Overweight especially obese, should pay attention to control weight, do appropriate exercise, wear suitable shoes, protect the foot, further to prevent the occurrence of foot injury and flatfoot.

     
    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Radiological assessment of the accuracy of screw placement for spinal fractures  
    Li Hong-rui, Yang Dong-mei, Li Ning-ning, Wu Jie
    2017, 21 (23):  3736-3740.  doi: 10.3969/j.issn.2095-4344.2017.23.022
    Abstract ( 369 )   PDF (910KB) ( 199 )   Save

    BACKGROUND: Volar locking plate is the domin Pedicle screw placement for spinal fractures with X-ray and CT assistant can optimize the accuracy of screw placement. Additionally, X-ray is cheap, repetitive and can reduce radiation injury, but has not been confirmed.

    OBJECTIVE: To evaluate the effect and imaging evaluation of X-ray in pedicle screw placement for spinal fractures.
    METHODS: Twenty patients with spinal fractures at T1-8 levels in our hospital from November 2014 to December 2016 were enrolled. The needles were placed along the pedicle axis at the middle of the pedicle, vertebral posterior and vertebral anterior, and its position was recorded by C-arm X-ray, 100 pedicle screws were placed under C-arm X-ray, and then evaluated by CT to analyze the application effect of X-ray.

    RESULTS AND CONCLUSION: The screw length between the actual placement at T1, T2, T3, T4, T5, T6, T7, T8 screw length under C-arm X-ray and virtual ones had no significant differences (P > 0.05), suggesting that X-ray can optimize the accuracy of screw placement. A total of 100 screws were placed, 94 screws were excellent, which were placed into the vertebral body completely, and the direction and depth were in accordance with the requirements. Six screws were good, some screws slightly worn out, but the cortical bone was less, and none was poor. No accident of pedicle violations was found. To conclude, C-arm X-ray-assisted screw placement for spinal fractures exhibits ideal outcomes.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程

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    Selection of implants and repair in posterolateral fractures of the tibial plateau
    Lu Yan-dong, Li Fang-guo, Miao Jun, Sun Jie
    2017, 21 (23):  3741-3746.  doi: 10.3969/j.issn.2095-4344.2017.23.023
    Abstract ( 559 )   PDF (926KB) ( 152 )   Save

    BACKGROUND: Tibial plateau fractures involving the posterolateral articular surface present a great challenge due to its complex anatomy. The posterolateral corner complex and the proximity of the common peroneal nerve restrict both the exposure of the joint surface and the ability to distract across the joint using a varus force.

    OBJECTIVE: To analyze the anatomy, morphology and classifications of the posterolateral fractures of the tibial plateau, and compare different surgical approaches and fixation materials.
    METHODS: A computer-based research of PubMed and CNKI databases was performed for the relative literatures published from 1990 to 2016 using the keywords of “tibial plateau, posterolateral fragment, fixation” in English and Chinese, respectively. The anatomy, morphology and typing of posterolateral fractures of the tibial plateau were analyzed and different surgical approaches and fixation materials were compared.
    RESULTS AND CONCLUSION: Posterolateral fractures of the tibial plateau should be treated in accordance with the intra-articular fracture principle, such as repairing joint surface to normal morphology, restoring the lower limb alignment, and maintaining joint mobility painlessly. Fractures are clarified according to Schatzker, AO, and three-column classification systems, but still need to be improved. To choose a proper surgical approach mainly depends on the fracture pattern. Biomechanics tests suggest that posterolateral locked plate exhibits excellent biomechanics characters, and can avoid the reduction loss caused by the shear force of fracture fragments. 

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Imaging methods and characters of fetal spinal cord development  
    He Yu-jie, Li Zhi-jun, Gao Shang, Wang Xing, Zhang Shao-jie, Li Kun, Kang Xiao-yan
    2017, 21 (23):  3747-3752.  doi: 10.3969/j.issn.2095-4344.2017.23.024
    Abstract ( 332 )   PDF (1072KB) ( 186 )   Save

    BACKGROUND: Fetal congenital malformation is an important cause of perinatal fetal death, in which neural tube defects (NTDs) in prenatal deformity screening is more common. In recent years, with the deterioration of environment and the increase in the number of elderly maternal, patients with NTDs are increasing, bringing serious social and family economic burden. Therefore, modern imaging methods are used to provide theoretical basis for prenatal screening NTDs.

    OBJECTIVE: To study the development of fetal spinal cord morphology by means of imaging, so as to provide reference for the diagnosis of prenatal screening.
    METHODS: A computer-based retrieval of CNKI, WanFang, VIP, CBM and PubMed databases was conducted for the report on the development of fetal spinal cord from 1959 to 2017, and their different imaging studies were summarized.
    RESULTS AND CONCLUSION: In view of the impact of radiation on pregnant women and the fetus, in order to better imaging, for different organizational structures using different detection methods. (1) X-ray and CT: due to radiation damage to pregnant women and fetuses, they are only used for the cadaveric spine ossification center development, X-ray has been abandoned, and CT has not seen a live report. (2) Ultrasound is easy to operate, and non-invasive for pregnant women and fetuses, which is the preferred method of inspection. (3) MRI, as an important supplement means of ultrasound, can provide imaging basis for the prenatal assessment of fetal spinal cord development and diagnosis of related diseases. (4) Noticeably, harm of radiation to fetus should be considered.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Evolution and status of unicompartmental knee prostheses  
    Wan Fu-yin, Guo Wan-shou
    2017, 21 (23):  3753-3759.  doi: 10.3969/j.issn.2095-4344.2017.23.025
    Abstract ( 670 )   PDF (1161KB) ( 264 )   Save

    BACKGROUND: Unicompartmental knee arthroplasty has been prevailed in orthopedics, but there is a lack of overview addressing unicompartmental knee prostheses.

    OBJECTIVE: To review the evolution and current situation of unicompartmental knee prostheses and to discuss its classifications, characters and clinical outcomes, thereby providing guidance for clinical application.
    METHODS: PubMed and WanFang databases were retrieved for the articles related to unicompartmental knee prostheses and its clinical outcomes. Totally 177 articles were retrieved, and finally 35 eligible articles plus other 4 reports were included after excluding repetitive studies.
    RESULTS AND CONCLUSION: (1) It has been more than 60 years since the birth of unicompartmental knee prostheses. Despite the difficult in the past, it comes to mature and the survival rate is more than 90% at 10 years. (2) At present, the most popular prostheses include mobile-bearing (represented by Oxford 3) and fixed-bearing(represented by ZUK and Link). There is no significant difference in clinical outcomes between two designs. However, their differences have been noted in their modes and timing of failures. (3) Aseptic loosening and lateral osteoarthritis progression remain the most common failure modes in unicompartmental knee prostheses. (4) Cementless prostheses and individual unicompartmental knee prostheses based on CT or MRI scan maybe promote the long-term efficacy of unicompartmental knee prostheses.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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    Advance in the treatment of senile unstable intertrochanteric fractures
    Huang Guan-yu, Peng Hao
    2017, 21 (23):  3760-3766.  doi: 10.3969/j.issn.2095-4344.2017.23.026
    Abstract ( 523 )   PDF (1411KB) ( 218 )   Save

    BACKGROUND: With more and more research available, there are different classification systems for intertrochanteric fracture, from Evans and Boyd-Griffin classification to Evans-Jensen and AO/OTA classification, all providing guidance for choosing an appropriate treatment scheme.

    OBJECTIVE: To review the advance in the treatment of senile unstable intertrochanteric fractures.
    METHODS: PubMed, Web of Science, WanFang and CNKI databases were searched with the keywords of “intertrochanteric fracture, intramedullary nail, hip arthroplasty” in English and Chinese, respectively. 1 535 literatures were retrieved firstly, and finally 47 articles were included in accordance with the inclusion and exclusion criteria.

    RESULTS AND CONCLUSION: The therapy conception of intertrochanteric fractures has been changed from conservative traction to early surgical treatment. With the development of technology, the internal fixators have been improved continuously. Screw-plate system has been developed from Jewett plate, AO/ASIF plate to dynamic hip screw. Intramedullary nails such as Gamma, proximal femoral and proximal femoral antirotation nails have been successfully applied in clinic. Senile patients with unstable intertrochanteric fractures also obtain favorable prognosis through active internal fixation, but the high incidence of complications appears because of osteoporosis, osteogenesis deficiency and accompanied by degenerative hip diseases. Thereafter, hip arthroplasty is recommended to treat senile unstable intertrochanteric fractures so as to achieve rapid functional recovery, desired efficacy and low incidence of complications. However, it still remains controversial to choose internal fixation or hip arthroplasty. 

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程

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    A meta-analysis of the efficacy of three-dimensional printing-assisted surgery for tibial plateau fractures  
    Shao Jia-shen, Chang Heng-rui, Zheng Zhan-le, Chen Wei, Zhang Ying-ze
    2017, 21 (23):  3767-3772.  doi: 10.3969/j.issn.2095-4344.2017.23.027
    Abstract ( 476 )   PDF (1030KB) ( 245 )   Save

    BACKGROUND: Three-dimensional (3D) printing technology exhibits a broad future in the orthopedics, especially exhibiting good guidance and auxiliary in the treatment of tibial plateau fractures. However, the related researches are few, and there is a lack of evidence-based medicine to confirm its application values.

    OBJECTIVE: To compare the efficacy of 3D printing-assisted surgery and traditional surgery in the treatment of tibial plateau fractures through a meta-analysis.
    METHODS: MEDLINE, Cochrane library, Embase, CBM, CNKI and WanFang databases were searched by computer and the relevant literatures were retrieved manually, to collect the controlled trials concerning the efficacy of 3D printing-assisted surgery versus traditional surgery for tibial plateau fractures. Methodology quality of the trials was assessed critically and relative data were extracted, followed by analysis on Stata 11.0 (Stata Corporation, College Station, TX) software.
    RESULTS AND CONCLUSION: (1) Seven controlled trials involving 362 patients were included. (2) Meta-analysis results showed that the 3D printing-assisted surgery had shorter operation time (SMD=-2.411, 95%CI=-2.718--2.104, P=0.00) and less intraoperative blood loss (SMD=-1.579, 95%CI=-1.842--1.316, P=0.00) than those in the traditional surgery. The excellent and good rate in Rasmussen and Hospital for Special Surgery knee scores showed no significant differences between two growps (P > 0.05). (3) To conclude, compared with the traditional surgery, the 3D printing-assisted surgery can significantly shorten the operation time and reduce the intraoperative blood loss in the treatment of tibial plateau fractures.

    中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
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